Impact of urban heat islands on morbidity and mortality in heat waves: observational time series analysis of Spain's five cities

Urban heat islands (UHIs) have become an especially relevant phenomenon as a consequence of global warming and the growing proportion of people living in cities. The health impacts that are sometimes attributed to the rise in temperature generated in an UHI are not always adequately justified. The objective is to analyse what effect UHIs have on maximum (Tmax) and minimum daily temperatures (Tmin) recorded in urban and non-urban observatories, and quantify the impact on morbidity and mortality during heat waves in Spain's five cities

The effect of cold waves on mortality in urban and rural areas of Madrid

While many studies analyze the effect of extreme thermal events on health, little has been written about the effects of extreme cold on mortality. This scarcity of papers is particularly relevant when we search studies about extreme cold on the health of rural population. Therefore, we tried to analyze the effect of cold waves on urban areas and rural areas from Madrid and to test whether differentiated effects exist between both population classes. For this purpose, we analyzed data from the municipalities with over 10,000 inhabitants for the period from January 1, 2000 through December 31, 2013. Municipalities were classified as urban or rural (Eurostat), and they were grouped into similar climatological zones: Urban Metropolitan Centre (UMC), Rural Northern Mountains (RNM), Rural Centre (RC) and Southern Rural (SR). The dependent variable was the daily mortality rate due to natural causes per million inhabitants (CIE-X: A00-R99) that occurred between the months of November and March for the period. The independent variable was minimum daily temperature (ºC) (Tmin). Social and demographic contextual variables were used, including: population > age 64 (%), deprivation index and housing indicators. The analysis was carried out in three phases: (1) determination of the threshold temperature (Tthreshold) which defines the cold waves; (2) determination of the relative risk (RR) for cold waves using Poisson linear regression (GLM); and (3) using GLM of the binomial family, Odds Ratios (OR) were calculated to analyze the relationship between the frequency of the appearance of cold waves and the socioeconomic variables.The authors gratefully acknowledge the grants for projects ENPY376/18; ENPY470/19 and ENPY 107/18 from the Carlos III Institute of Health

Does the meteorological origin of heat waves influence their impact on health? A 6-year morbidity and mortality study in Madrid (Spain)

In Spain, two synoptic-scale conditions influence heat wave formation. The first involves advection of warm and dry air masses carrying dust of Saharan origin. Objective: to determine whether the impact of heat waves on health outcomes in Madrid (Spain) during 2013–2018 varied by synoptic-scale condition.The authors wish to thank the funding provided by the ENPY 304/20, and ENPY 436/21 projects of the National Health Institute Carlos III (ISCIII)

Ultrasonographic Identification of Muscle Atrophy in Hamstring Muscles after Anterior Cruciate Ligament Repair among Soccer Players: A Case-control Study

Objectives To measure the CSA of the HST musculature measured with ultrasonography in soccer players undergoing ACLR and compare limb differences with healthy controls. Methods A case-control study was performed with patients after anterior cruciate ligament repair (ACLR) and healthy controls in which cross-sectional areas (CSA) obtained using a model TE7 ultrasound machine (MINDRAY ®, USA) in B mode (4.2 to 13 MHz) with a multifrequency linear array transducer (L12-4S). Three CSA images were taken of the semitendinosus muscle (ST) and the long head of the biceps femoris (BFlh), at a distance of 30% and 70% of the ischial tuberosity insertion. Mean differences between groups were analyzed using SPSS v.20 (IBM®, USA), and statistical analyses were performed using non-parametric techniques to determine differences between groups (Student's t-test) and Cohen's correlation coefficient to quantify effect size. Results 14 ACLR operated 17 ± 5.4 months ago and 12 healthy controls (W = 6; M = 20M; 24.5 ± 3.92 years; BMI = 25.1 ± 2.32 kg/m2) were recruited. There were differences between groups in CSA-ST70 (Post-ACLR = 1.43 ± 1.029 cm2 vs Control 2.65 ± 0.664 cm2, T Student = -3.68, 95% CI [-Inf, -0.648], P < 0. 001, ES = -1.418), but not in CSA-ST30 (Post-ACLR = 8.42 ± 1.596 cm2 vs Control 9.16 ± 0.945 cm2, T Student = -1.535; 95% CI [-Inf, -0.0793], P = 0. 068, ES = -0.5607), CSA-BFlh30 (Post-ACLR = 8.79 ± 1.47 cm2 vs Control 8.87 ± 2.312 cm2, T Student = -0.123; 95% CI [-Inf, 1.1049], P = 0.452, ES = -0. 049) or CSA-BFlh70 (Post-ACLR = 6.91 ± 1.011 cm2 vs Control 7.01 ± 1.453 cm2, T Student = -0.214; 95% CI [-Inf, 0.6795], P = 0.416, ES = -0.0783). Conclusion Ultrasound measurement of the CSA can be an image marker to identify muscle weakness or atrophy that predicts functional loss early

Effects of local factors on adaptation to heat in Spain (1983–2018)

The European Union is currently immersed in policy development to address the effects of climate change around the world. Key plans and processes for facilitating adaptation to high temperatures and for reducing the adverse effects on health are among the most urgent measures. Therefore, it is necessary to understand those factors that influence adaptation. The aim of this study was to provide knowledge related to the social, climate and economic factors that are related to the evolution of minimum mortality temperatures (MMT) in Spain in the rural and urban contexts, during the 1983–2018 time period. For this purpose, local factors were studied regarding their relationship to levels of adaptation to heat.The authors gratefully acknowledge the grants for projects ENPY107/18; ENPY 376/18, ENPY 470/19 and ENPY 340/20 from the Carlos III Institute of Health, and is supported by the Biodiversity Foundation of the Ministry for Ecological Transition and Demographic Challenge

Efectos de factores locales en la evolución de las temperaturas de mínima mortalidad en España (1983-2018)

Ponencia presentada en: XII Congreso de la Asociación Española de Climatología celebrado en Santiago de Compostela entre el 19 y el 21 de octubre de 2022.[ES]En la actualidad la Unión Europea se encuentra inmersa en decisiones políticas para combatir el cambio climático. Entre las medidas urgentes para abordar la emergencia climática se encuentran los planes y procesos claves para facilitar la adaptación a las altas temperaturas y reducir los efectos adversos en la salud de los habitantes. El objetivo de este estudio es conocer qué factores sociales, climáticos y económicos se han relacionado con la evolución de las temperaturas de mínima mortalidad (TMM) en España en los contextos rural y urbano, durante el periodo 1983-2018. Para ello, se estudiaron los factores locales en cuanto a su relación con los niveles de adaptación al calor.[EN]The European Union is currently engaged in policy decisions to combat climate change. Among the urgent measures to address the climate emergency are key plans and processes to facilitate adaptation to high temperatures and reduce adverse effects on people's health. The aim of this study was to provide knowledge related to the social, climate and economic factors that are related to the evolution of minimum mortality temperatures (MMT) in Spain in the rural and urban contexts, during the 1983–2018 time period. For this purpose, local factors were studied regarding their relationship to levels of adaptation to heat.Los autores agradecen las subvenciones para los proyectos ENPY107/18, ENPY 376/18 y ENPY 470/19 del Instituto de Salud Carlos III (ISCIII) con número de expediente ENPY 470/19, cuenta con el apoyo de la Fundación Biodiversidad, del Ministerio para la Transición Ecológica y el Reto Demográfico

Análisis de la vulnerabilidad al calor en zonas rurales y urbanas de España ¿qué factores pueden explicar su comportamiento geográfico?

Ponencia presentada en: XII Congreso de la Asociación Española de Climatología celebrado en Santiago de Compostela entre el 19 y el 21 de octubre de 2022.[ES]El objetivo de este estudio analizar la distinta vulnerabilidad al calor extremo entre poblaciones rurales y urbanas y determinar si este está determinado por variables socioeconómicas. Métodos: Estudio ecológico longitudinal y retrospectivo de series temporales, entre 01/01/2000 y 31/12/2013, en 42 áreas geográficas en 10 provincias de España. Primero, se determinó a partir de qué percentil de temperaturas estivales (Pthreshold)(junio-septiembre) se producen aumentos de mortalidad atribuibles a la ola de calor. Después, a partir de los Pthreshold se determinó la vulnerabilidad y analizó su distribución mediante modelos lineales mixtos de Poisson (link = log). En ellos, la variable dependiente fue la vulnerabilidad y las variables independientes la exposición a altas temperaturas, la aridez del clima, índice de privación, porcentaje de mayores de 65 años, índice de ruralidad, porcentaje de vivienda anterior a 1980 y estado de la vivienda.[EN]The aim of this study is to analyse the different vulnerability to extreme heat between rural and urban populations and to determine whether this is determined by socioeconomic variables. Methods: Longitudinal and retrospective ecological time series study, between 01/01/2000 and 31/12/2013, in 42 geographical areas in 10 provinces of Spain. First, we determined from which percentile of summer temperatures (Pthreshold) (June- September) mortality increases attributable to the heat wave occur. Then, from the Pthresholds, vulnerability was determined and its distribution analysed using Poisson linear mixed models (link = log). The dependent variable was vulnerability and the independent variables were exposure to high temperatures, climate aridity, deprivation index, percentage of people over 65 years old, rurality index, percentage of pre-1980 housing and housing condition

Adaptation to Heat and Social Health Inequalities according to Gender, Age and Territory: A Review of Studies Conducted in Spain (1983-2018)

[ES]Los efectos del cambio climático sobre la salud exacerban las desigualdades sanitarias y sociales existentes. La desigualdad expone a las poblaciones más vulnerables, haciéndolas más vulnerables a los daños y limitando su capacidad de adaptación. Para proteger a la población de las consecuencias del cambio climático es necesario conocer los factores que intervienen en los procesos de adaptación. Un indicador que permite evaluar la capacidad de adaptación al calor de una población es la Temperatura Mínima Mortalidad (TMM). A través de su evolución a lo largo del tiempo permite conocer si una población muestra adaptación o no.[PT]Os efeitos das alterações climáticas na saúde exacerbam as desigualdades sociais e de saúde existentes. A desigualdade expõe as populações mais vulneráveis, tornando-as mais vulneráveis a danos e limitando a sua capacidade de adaptação. Para proteger a população das consequências das alterações climáticas, é necessário conhecer os fatores que intervêm nos processos de adaptação. Um indicador que permite avaliar a capacidade de adaptação ao calor de uma população é a Temperatura de Mortalidade Mínima (TMM). Através da sua evolução ao longo do tempo, permite saber se uma população apresenta adaptação ou não.[EN]The health effects of climate change exacerbate existing health and social inequalities. Inequality exposes the most vulnerable populations, making them more vulnerable to damage and limiting their ability to adapt. In order to protect the population from the consequences of climate change it is necessary to understand the factors involved in adaptation processes. An indicator for assessing the adaptability to heat of a population is the Minimum Mortality Temperature (MMT). Its evolution over time makes it possible to know whether a population is adapting or not

Gender differences in adaptation to heat in Spain (1983–2018)

In Spain the average temperature has increased by 1.7 °C since pre-industrial times. There has been an increase in heat waves both in terms of frequency and intensity, with a clear impact in terms of population health. The effect of heat waves on daily mortality presents important territorial differences. Gender also affects these impacts, as a determinant that conditions social inequalities in health. There is evidence that women may be more susceptible to extreme heat than men, although there are relatively few studies that analyze differences in the vulnerability and adaptation to heat by sex. This could be related to physiological causes. On the other hand, one of the indicators used to measure vulnerability to heat in a population and its adaptation is the minimum mortality temperature (MMT) and its temporal evolution.The authors wish to thank the funding provided by the ENPY 304/20, ENPY 376/18 and ENPY 107/18 projects of the Carlos III Health Institute III (ISCIII)